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Infections and exposure to anti-infective agents and the risk of severe mental disorders: a nationwide study

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Köhler, O ; Petersen, L ; Mors, O ; Mortensen, P B ; Yolken, R H ; Gasse, C ; Benros, M E. / Infections and exposure to anti-infective agents and the risk of severe mental disorders : a nationwide study. I: Acta Psychiatrica Scandinavica. 2017 ; Bind 135, Nr. 2. s. 97-105.

Bibtex

@article{85bc51afd8cd46449b94edece8fa6aa3,
title = "Infections and exposure to anti-infective agents and the risk of severe mental disorders: a nationwide study",
abstract = "OBJECTIVE: Severe infections are associated with increased risks of mental disorders; however, this is the first large-scale study investigating whether infections treated with anti-infective agents in the primary care setting increase the risks of schizophrenia and affective disorders.METHOD: We identified all individuals born in Denmark 1985-2002 (N = 1 015 447) and studied the association between infections treated with anti-infective agents and the subsequent risk of schizophrenia and affective disorders during 1995-2013. Cox regression analyses were adjusted for important confounders.RESULTS: Infections treated with anti-infective agents were associated with increased risks of schizophrenia by a hazard rate ratio (HRR) of 1.37 (95{\%}-CI = 1.20-1.57) and affective disorders by a HRR of 1.64 (95{\%}-CI = 1.48-1.82), fitting a dose-response and temporal relationship (P < 0.001). The excess risk was primarily driven by infections treated with antibiotics, whereas infections treated with antivirals, antimycotics, and antiparasitic agents were not significant after mutual adjustment. Individuals with infections requiring hospitalization had the highest risks for schizophrenia (HRR = 2.05; 95{\%}-CI = 1.77-2.38) and affective disorders (HRR = 2.59; 95{\%}-CI = 2.31-2.89).CONCLUSION: Infections treated with anti-infective agents and particularly infections requiring hospitalizations were associated with increased risks of schizophrenia and affective disorders, which may be mediated by effects of infections/inflammation on the brain, alterations of the microbiome, genetics, or other environmental factors.",
keywords = "Adolescent, Adult, Anti-Infective Agents, Communicable Diseases, Denmark, Female, Hospitalization, Humans, Incidence, Male, Middle Aged, Mood Disorders, Proportional Hazards Models, Registries, Risk Factors, Schizophrenia, Young Adult, Journal Article",
author = "O K{\"o}hler and L Petersen and O Mors and Mortensen, {P B} and Yolken, {R H} and C Gasse and Benros, {M E}",
note = "{\circledC} 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2017",
month = "2",
doi = "10.1111/acps.12671",
language = "English",
volume = "135",
pages = "97--105",
journal = "Acta Psychiatrica Scandinavica",
issn = "0001-690X",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Infections and exposure to anti-infective agents and the risk of severe mental disorders

T2 - a nationwide study

AU - Köhler, O

AU - Petersen, L

AU - Mors, O

AU - Mortensen, P B

AU - Yolken, R H

AU - Gasse, C

AU - Benros, M E

N1 - © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2017/2

Y1 - 2017/2

N2 - OBJECTIVE: Severe infections are associated with increased risks of mental disorders; however, this is the first large-scale study investigating whether infections treated with anti-infective agents in the primary care setting increase the risks of schizophrenia and affective disorders.METHOD: We identified all individuals born in Denmark 1985-2002 (N = 1 015 447) and studied the association between infections treated with anti-infective agents and the subsequent risk of schizophrenia and affective disorders during 1995-2013. Cox regression analyses were adjusted for important confounders.RESULTS: Infections treated with anti-infective agents were associated with increased risks of schizophrenia by a hazard rate ratio (HRR) of 1.37 (95%-CI = 1.20-1.57) and affective disorders by a HRR of 1.64 (95%-CI = 1.48-1.82), fitting a dose-response and temporal relationship (P < 0.001). The excess risk was primarily driven by infections treated with antibiotics, whereas infections treated with antivirals, antimycotics, and antiparasitic agents were not significant after mutual adjustment. Individuals with infections requiring hospitalization had the highest risks for schizophrenia (HRR = 2.05; 95%-CI = 1.77-2.38) and affective disorders (HRR = 2.59; 95%-CI = 2.31-2.89).CONCLUSION: Infections treated with anti-infective agents and particularly infections requiring hospitalizations were associated with increased risks of schizophrenia and affective disorders, which may be mediated by effects of infections/inflammation on the brain, alterations of the microbiome, genetics, or other environmental factors.

AB - OBJECTIVE: Severe infections are associated with increased risks of mental disorders; however, this is the first large-scale study investigating whether infections treated with anti-infective agents in the primary care setting increase the risks of schizophrenia and affective disorders.METHOD: We identified all individuals born in Denmark 1985-2002 (N = 1 015 447) and studied the association between infections treated with anti-infective agents and the subsequent risk of schizophrenia and affective disorders during 1995-2013. Cox regression analyses were adjusted for important confounders.RESULTS: Infections treated with anti-infective agents were associated with increased risks of schizophrenia by a hazard rate ratio (HRR) of 1.37 (95%-CI = 1.20-1.57) and affective disorders by a HRR of 1.64 (95%-CI = 1.48-1.82), fitting a dose-response and temporal relationship (P < 0.001). The excess risk was primarily driven by infections treated with antibiotics, whereas infections treated with antivirals, antimycotics, and antiparasitic agents were not significant after mutual adjustment. Individuals with infections requiring hospitalization had the highest risks for schizophrenia (HRR = 2.05; 95%-CI = 1.77-2.38) and affective disorders (HRR = 2.59; 95%-CI = 2.31-2.89).CONCLUSION: Infections treated with anti-infective agents and particularly infections requiring hospitalizations were associated with increased risks of schizophrenia and affective disorders, which may be mediated by effects of infections/inflammation on the brain, alterations of the microbiome, genetics, or other environmental factors.

KW - Adolescent

KW - Adult

KW - Anti-Infective Agents

KW - Communicable Diseases

KW - Denmark

KW - Female

KW - Hospitalization

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Mood Disorders

KW - Proportional Hazards Models

KW - Registries

KW - Risk Factors

KW - Schizophrenia

KW - Young Adult

KW - Journal Article

U2 - 10.1111/acps.12671

DO - 10.1111/acps.12671

M3 - Journal article

VL - 135

SP - 97

EP - 105

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 2

ER -

ID: 51909445